Kornimate/medical-research-clean huggingface dataset:
evaluating the efficacy of deferasirox in transfusion dependent chronic anaemias (myelodysplastic syndrome, beta-thalassaemia patients) with chronic iron overload

Conditions: Myelodysplastic Syndromes; Beta-Thalassemia

Summary: this study will evaluate the safety and efficacy of deferasirox in transfusion dependent myelodysplastic syndrome, beta-thalassaemia major patients with chronic iron overload


Eligibility criteria:
inclusion criteria: * in- or outpatients with myelodysplasia / with risk of low or intermedier-1 according to the international prognostic scoring system (ipss) confirmed by bone marrow evaluation within 3 month/ or beta thalassaemia major patients, who have chronic iron overload, as a consequence of frequent blood transfusion * serum ferritin\> 1800 µg/l * age: 18-80 years * men and women * chronic iron overload caused by at least 30 units and maximum 100 units of blood of packed red blood cells * deferoxamin therapy is contraindicated or inadequate or unable to use in the recommended dose due to intolerability or other reason * eastern cooperative oncology group (ecog) performance status score between 0-2 * written informed consent exclusion criteria: * beta thalassaemia minor, * haemosiderosis caused by other than chronic transfusional iron overload, * patients with impaired renal function (creatinin clearance\< 60 ml/ min), * pregnancy, * lactation, * patient of childbearing potential unwilling to use contraceptive precautions * known hypersensitivity to deferasirox or any ingredients, * impaired hepatic function (sgot,sgpt 5x above unl). * patients severely ill due to underlying disease progression or other severe concomitant disease. * patients with poor prognosis of karyotype * patients with malabsorption caused by inflammatory bowel disease, gastrectomy, pancreatitis or other medical condition * history of nephrotic syndrome * significant proteinuria * patients with a previous history of clinically relevant ocular toxicity related to iron chelation * patients with positive test to hiv other protocol-defined inclusion/exclusion criteria may apply

Keywords: myelodysplastic syndromes beta-thalassemia iron overload iron chelating agents deferasirox
preoxygenation optimisation in obese patients

Conditions: Severe Obesity Design as BMI > 35kg/m2

Summary: oro-tracheal intubation in operating room in obese patients with bmi \> 35kg/m2 remains a critical event. the aim of this study is to determine whether nasal high flow therapy by nasal cannula optiflow® is more efficient than the bipap preoxygenation before orotracheal intubation after crash induction in obese patients

this study will be designed as followed : patients will be randomized in 2 groups : * preoxygenation during 4 minutes with high flow nasal cannula (60l/min fio2 (fraction of inspired oxygen) = 1) before orotracheal intubation after crash induction. the device will be maintained in place throughout the intubation procedure in order to achieve apnoeic oxygenation. * or preoxygenation during 4 minutes with bi-level positive airway pressure (bipap) with expiratory positive airway pressure (epap) + 5 cm h2o and inspiratory airway positive airway pressure (ipap) + 15, meaning a 10cm h2o pressure support. the facial mask with be removed after before crash induction enabling laryngoscopic vision.

Eligibility criteria:
inclusion criteria: * obese patient with bmi \> 35kg/m2 * age between 18 and 80 years * requiring a crash induction sequence for oro-tracheal intubation. exclusion criteria: * pulse oxymetry \< 90% in ambient air * haemodynamic instability * burned patient * indication of intubation vigil in spontaneous ventilation * patients with a documented cormack iv exposition before inclusion * protected adult * pregnancy * lack of consent * patient already enrolled in an other randomized study looking forward improving preoxygenation quality. * lack of french social protection
causes and patterns of anterior cruciate ligament injuries among egyptian population

Conditions: ACL Injury

Summary: the aim of work is to detect the patterns and the causes of acl injury among egyptian population and to identify its risk factors. identify the male to female ratio of injuries in our community. to document the patterns and frequencies of associated injuries

the acl (anterior cruciate ligament) is one of the most frequently injured ligaments of the knee, with a prevalence estimated to be 1 in 3000 in the us (greater than 120000 cases annually). acl injury frequently affects young, active individuals. it is also frequently associated with other structural injuries in the knee joint like meniscal tears and multi-ligamentous injuries. acl injury leads to increased laxity in the knee, predispose the knee to subsequent injuries and early onset osteoarthritis of the knee. sports related trauma is the commonest cause of acl rupture. females are reported to have 2 to 10-fold higher risk of injury than males playing the same sport. according to previous studies at assuit university hospital the impression was that the acl injuries are more common in males than females. additionally, non-sports injuries like motor cycle accidents and domestic injuries are expected to be a major cause of acl rupture, besides sports injuries, among egyptian population.

Eligibility criteria:
inclusion criteria: * patients with confirmed acl injury exclusion criteria: * patients with acl injury associated with fracture at the same limb

Keywords: acl injury non sport causes egyptians
gut microbiota, "spark and flame" of covid-19 disease

Conditions: COVID-19

Summary: elderly, hypertension, diabetes and cardiovascular diseases are risk factors for covid-19 morbility and mortality. however, the real reason for this is not yet understood. it is well documented that gut microbiota has a critical role in health, particularly in the immune system and therefore, we propose that gut microbiota composition could affect vulnerability and disease outcomes of covid-19.

in order to explore this hypothesis, we will analyse the gut microbiota of sarscov-2 infected patients categorized according to location: \[1\] ambulatory (self-isolation at home), \[2\] ward and \[1\] icu; and severity.

Eligibility criteria:
inclusion criteria: * adults of 18 years and above. * covid-19 patients. exclusion criteria: * none.

Keywords: covid-19 gut microbiota
benefit of one month zopiclone intake on adaptative servoventilation compliance

Conditions: Sleep Apnea, Central; Ventricular Dysfunction

Summary: the study evaluate the effect of adaptative servoventilation (asv) initiation combined with 14 days zopiclone vs placebo treatment in patients with central sleep apnea (csa) syndrome.

asv remain the optimal treatment for csa in heart failure patients with preserved left ventricular ejection fraction (lvef). yet, the adaptation to the ventilation is extremely challenging and the resulting difficulties encountered to sleep induction might be a reason for dropping out. zopiclone is indicated for the short-term treatment of insomnia where sleep initiation or sleep maintenance are prominent symptoms. in this study, zopiclone, as sedative and hypnotic agent, is used during the asv initiation period.

Eligibility criteria:
inclusion criteria: * male or female aged between 18 and 90 years at the initial visit * central sleep apnea with an ahi ≥ 15/h and at least 50% of central events indicating an asv therapy, as determined by a ventilatory polygraphy (pg) or a polysomnography (psg) * cardiac dysfunction with left ventricular ejection fraction(lvef)\> 45% determined by a transthoracic echocardiography (tte), known for more than 12 weeks and stable for at least 4 weeks; * compliance less than 3 hours after 7 days of the setting up of asv; * patient affiliated to a social security scheme or being beneficiary of such scheme; * patient voluntarily participating in the research, with written informed consent exclusion criteria: * current use of continuous positive airway pressure (cpap) for treatment of sleep apnea during the last 12 months * presence of chronic symptomatic heart failure with reduced left ventricular ejection fraction (lvef ≤ 45%), and a csa moderate to severe (ahi ≥15 / h) * presence of severe pulmonary bullous disease * presence of pneumothorax or pneumomediastinum * hypotension, especially if associated with depletion of intravascular volume * dehydration * leaking of cerebrospinal fluid, cranial surgery or trauma recently. * episode of acute respiratory failure or heart failure in the previous month
the effectiveness of alternating stimulation in preventing tolerance in essential tremor patients

Conditions: Essential Tremor; Deep Brain Stimulation

Summary: the purpose of this study is to investigate the hypothesis that alternating dbs parameters on a weekly basis will prevent tolerance to stimulation and thus waning of benefit, compared with non-alternating stimulation. the primary endpoint will be preserved tremor control with the alternating group compared with standard treatment using the tremor research group essential tremor rating assessment scale (tetras). key secondary endpoints will be preserved activities of daily living measures as well as preserved tremor control as quantified by motion sensor data. this study has one primary aim: to determine if alternating dbs stimulation parameters on a weekly basis will be superior at preserving tremor control compared with usual stimulation (non-alternating stimulation) in et patients with vim dbs.


Eligibility criteria:
inclusion criteria: 1. patients with clinically diagnosed et who have had placement of vim dbs and are willing to undergo a baseline programming visit and 12-week follow-up assessment 2. at least initial benefit from vim dbs as judged by patient report and clinician exam 3. vim dbs placement no less than three months from entry into study 4. patients must demonstrate ability to use patient programmer to switch between group settings on a weekly basis 5. ability to wear wrist monitor for 2 week intervals, twice during the study 6. patients with the following ipg types: activa pc, sc or rc exclusion criteria: 1. atypical tremor disorder including but not limited to tremor due to multiple sclerosis, medication-induced tremor, parkinson's disease or parkinsonian syndrome 2. dbs placement complicated by infection, hemorrhage or stroke 3. previous thalamotomy (either stereotactic, gamma knife or focused ultrasound) or previous dbs surgery resulting in explantation and reimplantation 4. known incorrect or poor lead placement 5. inability to change group settings on a weekly basis at least 75% of the time 6. inability to tolerate 12-week period without additional programming changes, including voltage stimulation adjustment 7. inability to tolerate 12-week period without adjustment of anti-tremor medications, including primidone, beta-blockers, gabapentin, topiramate and/or benzodiazepines 8. battery voltage \< or equal to 2.70v 9. patient with the following ipg types: soletra, kinetra or itrel 10. inability to tolerate two group settings due to side effects or lack of efficacy
goal management training for parkinson disease mild cognitive impairment

Conditions: Parkinson Disease; Mild Cognitive Impairment

Summary: mild cognitive impairment is experienced by approximately 30% of patients with parkinson's disease (pd-mci), often affecting executive functions. there is currently no pharmacological treatment available for pd-mci and non-pharmacological treatments are still scarce. the aim of this study was to test preliminary efficacy/effectiveness of two home-based cognitive interventions adapted for patients with pd-mci: goal management training, adapted for pd-mci (adapted-gmt), and a psychoeducation program combined with mindfulness exercises. twelve persons with pd-mci with executive dysfunctions, as measured by extensive neuropsychological evaluation, were randomly assigned to one of two intervention groups. both groups received five sessions each lasting 60-90 minutes for five weeks, in presence of the caregiver. measures were collected at baseline, mid-point, at one-week, four-week and 12-week follow-ups. primary outcomes were executive functions assessed by subjective (dex questionnaire patient- and caregiver-rated) and objective (zoo map test) measures. secondary outcomes included quality of life (pdq-39), global cognition (drs-ii), and neuropsychiatric symptoms (npi-12). safety data (fatigue, medication change and compliance) were also recorded. repeated measures ancovas were applied to outcomes. both groups significantly ameliorated executive functions overtime as indicated by improvements in dex-patient and dex-caregiver scores. pdq-39 scores decreased at the four-week follow-up in the psychoeducation/mindfulness group whereas they were maintained in the adapted-gmt group. all other measures were maintained over time in both groups. adapted-gmt and psychoeducation/mindfulness groups both improved executive functioning. this is one of the first studies to test home-based approaches, tailored to the participant's cognitive needs, and involving caregivers.


Eligibility criteria:
inclusion criteria: 1. pd diagnosis from the united kingdom research brain bank diagnostic criteria for pd (hughes et al., 1992); 2. pd-mci diagnosis from the movement disorder society task force diagnostic criteria. single and multiple-domain mci were both included, only if executive functions were significantly impaired (-1 standard deviation on executive function tests according to age and education-adjusted norms); 3. montreal cognitive assessment scores between 21 and 27; 4. anti-parkinson medication stable (at screening) since at least two months; 5. all other medications, including psychotropics, stable for at least three months. exclusion criteria: 1. participants with pd and dementia diagnosis 2. patients with other neurological or psychiatric disorders.

Keywords: mild cognitive impairment parkinson disease cognitive intervention goal management training executive functions
remote-by-default care in the covid-19 pandemic

Conditions: COVID-19

Summary: 18 month study, funded by esrc covid-19 research fund. the aim is to explore and support the rapid shift from face-to-face to remote (telephone and video) conversations in primary care. there are three components: a study of clinical interactions and decision making (micro); four locality-based organisational case studies of new models of care (meso); abd a a study of how digital innovation can support nhs infrastructure and vice versa (macro).

18 month study, funded by esrc covid-19 research fund. the aim is to explore and support the rapid shift from face-to-face to remote (telephone and video) conversations in primary care. there are three components: a study of clinical interactions and decision making (micro); four locality-based organisational case studies of new models of care (meso); abd a a study of how digital innovation can support nhs infrastructure and vice versa (macro). the methods are mainly qualitative (interviews, virtual ethnography, analysis of documents, micro-analysis of conversations) and are designed to inform action research. key deliverables: at least two evidence-based assessment tools: qualitative (questions for remote assessment of breathlessness) and quantitative (a covid-19-specific early warning score) transferable lessons about how to achieve rapid spread and scale-up, spread in real time through our extensive intersectoral networks strengthened infrastructure for supporting digital innovation in the nhs

Eligibility criteria:
inclusion criteria: * inclusion criteria for interviews willing and able to give informed consent for participation aged 18 years or above staff involved in delivering remote-by-default services in the frontline or 'back offices' patients/carers who have crossed paths with primary care services during the covid pandemic. pharmacy case studies: staff involved in delivering remote pharmacist consultation services in the frontline or 'back offices' patients/carers who have crossed paths with community pharmacy primary care services during the covid-19 pandemic. inclusion criteria for video and telephone consultations patients who have remote primary care consultation regarding symptoms associated with covid-19 and their clinicians (based in oxford/thames valley) who have agreed to participate in the study inclusion criteria for focus groups patients that have experienced self-reported 'long covid' symptoms (for patient only focus groups) clinicians that have experienced self-reported 'long covid' symptoms (for clinician only focus groups) exclusion criteria: patients or clinicians who are too ill to be interviewed -
managing transient neurologic episodes in surgery for moyamoya disease

Conditions: Moya Moya Disease

Summary: the goal of this study is to study the incidence of post-operative transient neurologic events (tnes) within 30 days postoperatively, as assessed by clinical neurological scales, binned by week. collect data on all interventions and assessments performed during the recovery post surgery up to 30 days, to understand what factors might cause transient neurologic events (tnes) and determine how these can be reduced in moyamoya subjects post surgery.


Eligibility criteria:
inclusion criteria: * moyamoya disease (mmd) patients undergoing direct extracranial-intracranial (ecic) bypass. patients above the age of 3 years old are eligible for the study exclusion criteria: * renal dysfunction, electrolyte disturbances neuromuscular disorders including myaesthenia gravis, heart block
effect of nitrate supplementation on blood pressure and microvascular function of resistant hypertensive patients

Conditions: Arterial Hypertension; Resistant Hypertension; Microvascular Function; Nitrate Supplementation

Summary: arterial hypertension (ah) has been identified as an important public health problem and considered a new epidemic with high mortality and morbidity. high blood pressure (bp) levels increase the chances of coronary artery disease (cad), heart failure (hf), stroke, chronic renal failure (crf) and death. beetroot powder may be an easier way to increase the availability of nitric oxide and consequently vasodilation in these patients. however, studies are needed to evaluate its benefits in patients with ah.


Eligibility criteria:
inclusion criteria: * resistant hypertension, with a diagnosis described in the medical record, without changing medications or increasing doses in the last 30 days. exclusion criteria: * neoplasms * heart failure * use of medications with nitrate in their formula * patients undergoing renal denervation

Keywords: microcirculation capillary density microvascular reactivity systemic resistant hypertension
rapid hiv testing program in the emergency department

Conditions: HIV Infections

Summary: the purpose of the study is to evaluate the feasibility of a rapid hiv testing program in the temple university hospital(tuh)emergency department. we hypothesize that a rapid hiv testing program in the tuh emergency department is feasible. patients presenting to the adult tuh emergency department with certain conditions will be offered rapid hiv testing. testing will be performed by oral swab using the oraquick advance test. patients will receive post-test counseling.


Eligibility criteria:
inclusion criteria: one of the following conditions: * sexually transmitted disease evaluation or prior history of sexually transmitted disease * pregnancy * clinical condition that suggests possible immunodeficiency * history of illicit drug use * history of chronic viral hepatitis * patients with unexplained pneumonia or recurrent pneumonia * male patients who have a history of sex with men * abdominal pain in a sexually active woman or urethritis in a man * trauma. * age 18 years old or older. exclusion criteria: * age less than 18 years. * none of the above conditions.

Keywords: hiv emergency department hiv seronegativity
inpatient and outpatient balloon catheter cervical ripening

Conditions: Caesarean Section; Infection

Summary: a randomised controlled trial comparing cervical ripening using foley catheter as in- or outpatient setting.

the study evaluated the efficacy and safety of outpatient versus inpatient foley catheter cervical ripening and patients' satisfaction. sixty low-risk women were randomized to outpatient and inpatient management of intracervical foley catheter digital insertion. the outpatient group was provided with verbal and written 24-hours contact information and instructions. both groups were reassessed the next morning unless labor had begun or the catheter had dropped off.

Eligibility criteria:
inclusion criteria: * singleton * gestational age beyond 37 weeks * cephalic presentation * intact membranes * bishop score less than 6 * lives within 10km from national university malaysia medical centre or able to reach within 30 minutes * readily available transport exclusion criteria: * intrauterine death * intrauterine fetal growth restriction * estimated fetal weight more than 4000gram * fetal anomalies * abnormal pre-induction cardiotocograph * non-vertex presentation * unstable lie * sepsis * hypertension * allergy to latex * previous uterine scar * history of antepartum haemorrhage * parity of 6 and more * placenta praevia * suspected cephalopelvic disproportion

Keywords: cervical ripening foley catheter patient satisfaction